Surgery for renal artery aneurysms: a combined series of two large centers.
OBJECTIVE
To review the clinical features and results of surgical treatment of renal artery aneurysms from two large centers.


METHODS
A retrospective analysis of 21 hypertensive patients with renal artery aneurysms operated in two centers during a 24-year period was performed.


RESULTS
The presenting symptom was subcostal or flank pain in 8 (38%) and hematuria in 5 (24%) cases. A ring-like calcification was seen on plain X-ray in 6 (29%) cases. All patients were evaluated with renal angiography showing a saccular aneurysm in 13 cases (62%), fusiform in 5 (24%) and dissecting in 3 (14%) cases. All saccular aneurysms were treated with resection followed by reconstruction with vein patch in 10 cases, and with and end-to-end anastomosis in 3 cases. All fusiform and dissecting aneurysms were managed with resection and reconstruction using aortorenal bypass. There was no hospital mortality or significant morbidity. During a follow-up ranging from 6 months to 23 years, there was definite cure of hypertension in 14 (67%) patients and improvement of blood pressure levels in 4 (19%) patients. Three patients continued to be hypertensive.


CONCLUSIONS
Surgery for renal artery aneurysms can be accomplished with good results and should be considered for patients with aneurysms greater than 2 cm, for aneurysms causing renovascular hypertension, significant stenosis, flank pain, or hematuria, for dissecting, expanding and thrombotic aneurysms, and in women with a potential for pregnancy. However, all aneurysms cannot and should not be treated surgically.
Bastounis
E
E
1st Department of Surgery, University of Athens, Greece.
Pikoulis
E
E
Georgopoulos
S
S
Alexiou
D
D
Leppäniemi
A
A
Boulafendis
D
D
D015746:Abdominal Pain / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001012:Aorta, Abdominal / Q000601:surgery; D001027:Aortography; D005260:Female; D006115:Greece; D006417:Hematuria / Q000000981:diagnostic imaging; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000601:surgery; D013781:Texas; D016896:Treatment Outcome